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神经源性膀胱膀胱测压形态学定义的科学研究进展:叙述性综述

Evolution of Scientific Efforts to Define Cystometric Bladder Morphology in Neurogenic Bladder: A Narrated Review.

作者信息

Sinha Arvind, Aithal Shrilakshmi

机构信息

Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

出版信息

J Indian Assoc Pediatr Surg. 2025 May-Jun;30(3):265-270. doi: 10.4103/jiaps.jiaps_247_24. Epub 2025 Mar 3.

DOI:10.4103/jiaps.jiaps_247_24
PMID:40406314
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12094606/
Abstract

Children with high-pressure bladders are at an increased risk of upper tract deterioration, potentially leading to chronic renal failure if not adequately managed. Regular bladder pressure monitoring is essential, especially in patients with neurogenic bladders, often resulting from spinal dysraphism. Urodynamic studies (UDSs) are the gold standard for assessing bladder pressure but are invasive, resource-intensive, and uncomfortable for patients. Over the last many decades, there have been regular attempts to characterize the morphology of the neurogenic bladder, including the classical subjective appearance of the "Christmas Tree" bladder, to objectively define the shape of the bladder via the use of height-to-width ratio. The study explores the evolution of scientific efforts to define bladder morphology in neurogenic bladder and to describe the current state of evidence regarding the correlation of the shape of the bladder with the detrusor pressures and upper tract changes in children with neurogenic bladder.

摘要

膀胱高压的儿童上尿路恶化风险增加,如果管理不当可能导致慢性肾衰竭。定期监测膀胱压力至关重要,尤其是对于神经源性膀胱患者,这类患者通常由脊柱裂引起。尿动力学研究(UDS)是评估膀胱压力的金标准,但具有侵入性、资源密集且让患者不适。在过去几十年里,人们一直在定期尝试描述神经源性膀胱的形态,包括经典的主观外观“圣诞树”膀胱,并通过使用高宽比来客观定义膀胱形状。本研究探讨了在神经源性膀胱中定义膀胱形态的科学努力的演变,并描述了目前关于神经源性膀胱患儿膀胱形状与逼尿肌压力及上尿路变化之间相关性的证据状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d186/12094606/f98709c3f25e/JIAPS-30-265-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d186/12094606/dceb143dedca/JIAPS-30-265-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d186/12094606/ded4a2185f4a/JIAPS-30-265-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d186/12094606/014f2382d4b7/JIAPS-30-265-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d186/12094606/129810518a11/JIAPS-30-265-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d186/12094606/f98709c3f25e/JIAPS-30-265-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d186/12094606/dceb143dedca/JIAPS-30-265-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d186/12094606/ded4a2185f4a/JIAPS-30-265-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d186/12094606/014f2382d4b7/JIAPS-30-265-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d186/12094606/129810518a11/JIAPS-30-265-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d186/12094606/f98709c3f25e/JIAPS-30-265-g005.jpg

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本文引用的文献

1
Bladder height to width ratio as a surrogate marker for non-physiological storage pressures in children with spinal dysraphism.膀胱高度与宽度比值可作为脊柱裂患儿非生理性储尿期压力的替代标志物。
Pediatr Surg Int. 2024 Apr 29;40(1):114. doi: 10.1007/s00383-024-05696-y.
2
A simple screening tool for an unfavorable bladder in children with myelomeningocele: Is the height to width ratio of the cystogram useful to predict high-pressure bladder?一种用于筛查脊髓脊膜膨出患儿膀胱功能不良的简易工具:膀胱造影的高宽比对于预测高压性膀胱是否有用?
J Pediatr Urol. 2020 Dec;16(6):839.e1-839.e5. doi: 10.1016/j.jpurol.2020.09.015. Epub 2020 Sep 21.
3
Development and validation of a bladder trabeculation grading system in pediatric neurogenic bladder.
小儿神经性膀胱中膀胱小梁形成分级系统的建立与验证。
J Pediatr Urol. 2020 Jun;16(3):367-370. doi: 10.1016/j.jpurol.2020.03.007. Epub 2020 Mar 19.
4
The "Christmas tree" bladder.“圣诞树”样膀胱。
Abdom Radiol (NY). 2018 Dec;43(12):3525-3526. doi: 10.1007/s00261-018-1648-3.
5
Is a closed bladder neck on preoperative videourodynamic studies an important factor for continence following augmentation ileocystoplasty in myelodysplastic patients?术前尿动力学研究中膀胱颈闭合是骨髓发育不良患者行回肠代膀胱术后控尿的重要因素吗?
J Pediatr Urol. 2013 Jun;9(3):293-7. doi: 10.1016/j.jpurol.2012.05.002. Epub 2012 May 30.
6
Severe bladder trabeculation obviates the need for bladder outlet procedures during augmentation cystoplasty in incontinent patients with neurogenic bladder.严重的膀胱小梁形成使得神经源性膀胱失禁患者在膀胱扩大成形术期间无需进行膀胱出口手术。
BJU Int. 2008 Jan;101(2):223-6. doi: 10.1111/j.1464-410X.2007.07164.x. Epub 2007 Oct 26.
7
The radiographic findings in neurogenic bladder.神经源性膀胱的影像学表现。
Radiology. 1961 May;76:795-800. doi: 10.1148/76.5.795.
8
Structural basis of neurogenic bladder dysfunction. II. Myogenic basis of detrusor hyperreflexia.神经源性膀胱功能障碍的结构基础。II. 逼尿肌反射亢进的肌源性基础。
J Urol. 2003 Feb;169(2):547-54. doi: 10.1097/01.ju.0000042667.26782.c7.
9
What volume can a child normally store in the bladder at a safe pressure?在安全压力下,儿童膀胱通常能储存多少尿液?
J Urol. 1993 Mar;149(3):561-4. doi: 10.1016/s0022-5347(17)36148-7.
10
Prognostic value of urodynamic testing in myelodysplastic patients.尿动力学检查在骨髓增生异常患者中的预后价值
J Urol. 1981 Aug;126(2):205-9. doi: 10.1016/s0022-5347(17)54449-3.